[The radical minimal access thoracoplasty by funnel chest in adults].

A new technique of radical thoracoplasty, performed with a small size incision, using the sternocostal complex fixation with nitinol plates with shape memory and the surgical toolkit required for the purpose, has been successfully introduced. 23 patients underwent surgery using the technique. Tree patients had early postoperative complications: 2 cases of exudative pleurisy and 1 case of bronchitis aggravation. Good cosmetic results was achieved in all operated patients. The mechanical ground of the technique is based on the use of the effective force of the sternum traction and the pressure of the plate on the tissues below. The main advantage of the method is avoidance of the transverse sternotomy.

[Radical thoracoplasty by the funneled thorax malformation in adults].

Early and long-term results of radical thoracoplasty in 114 adult patients with funnel chest are presented. The Sulamaa-Paltia operation was performed in 24 patients, thoracoplasty with sternocostal complex fixing by arcuated nitinol plates was made in 30 patients. Thoracoplasty with sternocostal complex fixing by M-shaped nitinol plates was performed in 60 cases. Two patients after Sulamaa-Paltia operation demonstrated the plate displacement, which caused the relapse of the disease. Those patients, who had other techniques applied, showed no signs of relapse. Thus, Sulamaa-Paltia operation allowed good results in 83,3% of the treated patients; the use of arcuated and M-shaped plates showed good results in 93,3 and 98,3%, respectively.

[Application of damper craniofixators from nitinol in plasty of skull defects].

An overview of the methods of fixation of the skull bones is presented,as well as discussion and characterization of different methods of fixation. A new system of fixation of the skull bones was used in osseous-plastic trepanation and reconstructive operations using nitinol craniofixators. Results of cranioplasty using craniofixators were analyzed in 62 patients with craniocerebral injuries and its consequences, vascular and oncological diseases of the brain. There were no complications in the postoperative period. Articles made of nitinol are very strong, elastic and have the effect of thermo-mechanical memory of the form.

[Clinical studies of transpedicular system using TiNi rod with functionally optimal rigidity].

Transpedicular metal systems are very widely applied in surgical treatment of spinal pathology. Recently TiNi constructions were introduced into practice. This material is characterized by shape memory, superior elasticity and cyclic durability. Adequacy of mechanical interactions of tissues and TiNi-based alloys allows to suggest that TiNi systems are more physiological and functional in comparison with steel and titanium alloys. This enabled development of transpedicular TiNi system with good safety and stability properties in combination with physiologic compatibility and high functional value of TiNi connections. We performed computer modeling of different spine lesions treated by transpedicular systems using ANSYS program kit. Statistic and cyclic tests of transpedicular systems were made using test machine 'Terotest' according to international standards. Results of studies allowed to formulate guidelines for application of transpedicular systems with different level of rigidity in treatment of injuries and degenerative lesions of the spine. The authors performed 53 operations in patients with lesions of lower-thoracic and lumbar spine using TiNi rod with functionally optimal rigidity and obtined good postoperative results.

[Experimental and clinical substantiation of the functional transpedicular stabilization of the vertebral column]. / Eksperimental'no-klinicheskoe obosnovanie funktsional'noi transpedikuliarnoi stabilizatsii pozvonochnika.

Metallic construction for transpecular stabilization (transpedicular constructions T-TPC). Titanium nickelide (TiNi) alloys have come into existence in the surgical treatment of diseases of the vertebral column and spinal cord. The properties of these alloys are the storage of a shape, superelasticity, and cyclic longevity. The adequate mechanical behavior of live tissues and TiNi-based alloys suggests that metallic constructions made from TiNi are more physiological and functional than those made from steels and titanium alloys. The foregoing makes it possible to consider the design of metallic constructions to be promising for transpedicular spinal stabilization involving the latter's reliability and stability with the physiological and functional capacities of TiNi fixing arms. The study performed computer-assisted simulation of surgical treatment for different spinal diseases by using TPC by means of the programme package ANSYS and statistical and cyclic studies of TPC up to the international standards on a Terotest testing machine. The experimental findings were used to formulate recommendation to use TPC of varying rigidity to treat spinal injuries and diseases. Eight operations were performed to treat patients with diseases of the lower thoracic and lumbar parts of the vertebral column, by using TiNi rod of the optimum rigidity, which yielded good clinical results.